Sanchini Chiara, Papia Chiara, Cutaia Chiara, Poloni Tino Emanuele, Cesari Matteo
Geriatric Fellowship Program, University of Milan, Milan, Italy.
Istituto Golgi Redaelli, Milan, Italy.
Ann Geriatr Med Res. 2023 Mar;27(1):80-82. doi: 10.4235/agmr.22.0128. Epub 2023 Feb 6.
Lyme disease is an uncommon cause of reversible dementia. A 75-year-old male patient, with a personal history of mild memory deficit, was admitted to Alzheimer's Disease Care Unit due to hallucinations, confusion and aggressive behavior unresponsive to antipsychotic therapy. A computed tomography (CT) scan of the brain was negative, while blood exams showed a rise in inflammatory parameters. A complete screening of infective diseases showed a positive serology for Borrelia burgdorferi, confirmed at Western blot. Even though the patient refused cerebrospinal fluid (CSF) exam, the brilliant clinical improvement after the appropriate antimicrobial therapy is strongly suggestive for a diagnosis of neuroborreliosis. This case report underlines the importance of a diagnostic approach to dementia, as to find out and treat the reversible causes.
莱姆病是可逆性痴呆的一种罕见病因。一名75岁男性患者，有轻度记忆缺陷个人史，因幻觉、意识模糊及对抗精神病药物治疗无反应的攻击性行为入住阿尔茨海默病护理单元。脑部计算机断层扫描（CT）结果为阴性，而血液检查显示炎症指标升高。全面的传染病筛查显示伯氏疏螺旋体血清学呈阳性，免疫印迹法予以证实。尽管患者拒绝进行脑脊液（CSF）检查，但适当的抗菌治疗后显著的临床改善强烈提示为神经莱姆病诊断。本病例报告强调了痴呆诊断方法的重要性，以便找出并治疗可逆性病因。
